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TAXABLE PENSION/ANNUITY AMOUNT: $0.00

RENT/ROYALTY/PARTNERSHIP/ESTATE (Schedule E): $0.00

RENT/ROYALTY/PARTNERSHIP/ESTATE (Schedule E) PER COMPUTER: $0.00

RENT/ROYALTY INCOME/LOSS PER COMPUTER: $0.00

ESTATE/TRUST INCOME/LOSS PER COMPUTER: $0.00

PARTNERSHIP/S-CORP INCOME/LOSS PER COMPUTER: $0.00

FARM INCOME OR LOSS (Schedule F): $0.00

FARM INCOME OR LOSS (Schedule F) PER COMPUTER: $0.00

UNEMPLOYMENT COMPENSATION: $0.00

TOTAL SOCIAL SECURITY BENEFITS: $0.00

TAXABLE SOCIAL SECURITY BENEFITS: $0.00

TAXABLE SOCIAL SECURITY BENEFITS PER COMPUTER: $0.00

OTHER INCOME: $0.00

SCHEDULE EIC SE INCOME PER COMPUTER: $0.00

SCHEDULE EIC EARNED INCOME PER COMPUTER: $0.00

SCH EIC DISQUALIFIED INC COMPUTER: $0.00

TOTAL INCOME: $0.00

TOTAL INCOME PER COMPUTER: $0.00

Adjustments to Income

EDUCATOR EXPENSES: $0.00

EDUCATOR EXPENSES PER COMPUTER: $0.00

RESERVIST AND OTHER BUSINESS EXPENSE: $0.00

HEALTH SAVINGS ACCT DEDUCTION: $0.00

HEALTH SAVINGS ACCT DEDUCTION PER COMPTR: $0.00

MOVING EXPENSES: F3903: $0.00

SELF EMPLOYMENT TAX DEDUCTION: $0.00

SELF EMPLOYMENT TAX DEDUCTION PER COMPUTER: $0.00

KEOGH/SEP CONTRIBUTION DEDUCTION: $0.00

SELF-EMP HEALTH INS DEDUCTION: $0.00

EARLY WITHDRAWAL OF SAVINGS PENALTY: $0.00

ALIMONY PAID SSN:

ALIMONY PAID: $0.00

IRA DEDUCTION: $0.00

IRA DEDUCTION PER COMPUTER: $0.00

STUDENT LOAN INTEREST DEDUCTION: $0.00

STUDENT LOAN INTEREST DEDUCTION PER COMPUTER: $0.00

TUITION AND FEES DEDUCTION: $0.00

TUITION AND FEES DEDUCTION PER COMPUTER: $0.00

JURY DUTY PAY DEDUCTION: $0.00

DOMESTIC PRODUCTION ACTIVITIES DEDUCTION: $0.00

OTHER ADJUSTMENTS: $0.00

ARCHER MSA DEDUCTION: $0.00

ARCHER MSA DEDUCTION PER COMPUTER: $0.00

TOTAL ADJUSTMENTS: $0.00

TOTAL ADJUSTMENTS PER COMPUTER: $0.00

ADJUSTED GROSS INCOME: $0.00

ADJUSTED GROSS INCOME PER COMPUTER: $0.00

Tax and Credits

65-OR-OVER: NO

BLIND: NO

SPOUSE 65-OR-OVER: NO

SPOUSE BLIND: NO

STANDARD DEDUCTION PER COMPUTER: $0.00

ADDITIONAL STANDARD DEDUCTION PER COMPUTER: $0.00

(3)

TAX TABLE INCOME PER COMPUTER: $0.00

EXEMPTION AMOUNT PER COMPUTER: $0.00

TAXABLE INCOME: $0.00

TAXABLE INCOME PER COMPUTER: $0.00

TOTAL POSITIVE INCOME PER COMPUTER: $0.00

TENTATIVE TAX: $0.00

TENTATIVE TAX PER COMPUTER: $0.00

FORM 8814 ADDITIONAL TAX AMOUNT: $0.00

TAX ON INCOME LESS SOC SEC INCOME PER COMPUTER: $0.00

FORM 6251 ALTERNATIVE MINIMUM TAX: $0.00

FORM 6251 ALTERNATIVE MINIMUM TAX PER COMPUTER: $0.00

FOREIGN TAX CREDIT: $0.00

FOREIGN TAX CREDIT PER COMPUTER: $0.00

FOREIGN INCOME EXCLUSION PER COMPUTER: $0.00

FOREIGN INCOME EXCLUSION TAX PER COMPUTER: $0.00

CHILD & DEPENDENT CARE CREDIT: $0.00

CHILD & DEPENDENT CARE CREDIT PER COMPUTER: $0.00

CREDIT FOR ELDERLY AND DISABLED: $0.00

CREDIT FOR ELDERLY AND DISABLED PER COMPUTER: $0.00

EDUCATION CREDIT: $0.00

EDUCATION CREDIT PER COMPUTER: $0.00

GROSS EDUCATION CREDIT PER COMPUTER: $0.00

RETIREMENT SAVINGS CNTRB CREDIT: $0.00

RETIREMENT SAVINGS CNTRB CREDIT PER COMPUTER: $0.00

PRIM RET SAV CNTRB: F8880 LN6A: $0.00

SEC RET SAV CNTRB: F8880 LN6B: $0.00

TOTAL RETIREMENT SAVINGS CONTRIBUTION: F8880 CMPTR: $0.00

RESIDENTIAL ENERGY CREDIT: $0.00

RESIDENTIAL ENERGY CREDIT PER COMPUTER: $0.00

CHILD TAX CREDIT: $0.00

CHILD TAX CREDIT PER COMPUTER: $0.00

ADOPTION CREDIT: F8839: $0.00

ADOPTION CREDIT PER COMPUTER: $0.00

FORM 8839 REFUND ADOPTION CREDIT AMOUNT: $0.00

DC 1ST TIME HOMEBUYERS CREDIT: $0.00

DC 1ST TIME HOMEBUYERS CREDIT PER COMPUTER: $0.00

FORM 8396 MORTGAGE CERTIFICATE CREDIT: $0.00

FORM 8396 MORTGAGE CERTIFICATE CREDIT PER COMPUTER: $0.00

F3800, F8801 AND OTHER CREDIT AMOUNT: $0.00

FORM 3800 GENERAL BUSINESS CREDITS: $0.00

FORM 3800 GENERAL BUSINESS CREDITS PER COMPUTER: $0.00

FORM 1040C CREDIT: $0.00

PRIOR YR MIN TAX CREDIT: F8801: $0.00

PRIOR YR MIN TAX CREDIT: F8801 PER COMPUTER: $0.00

F8834 ELECTRIC VEHICLE CREDIT AMOUNT: $0.00

F8936 ELECTRIC MOTOR VEHICLE CREDIT AMOUNT: $0.00

F8910 ALTERNATIVE MOTOR VEHICLE CREDIT AMOUNT: $0.00

OTHER CREDITS: $0.00

TOTAL CREDITS: $0.00

TOTAL CREDITS PER COMPUTER: $0.00

INCOME TAX AFTER CREDITS PER COMPUTER: $0.00

Other Taxes

SE TAX: $0.00

SE TAX PER COMPUTER: $0.00

SOCIAL SECURITY AND MEDICARE TAX ON UNREPORTED TIPS: $0.00

(4)

SOCIAL SECURITY AND MEDICARE TAX ON UNREPORTED TIPS PER COMPUTER: $0.00

TAX ON QUALIFIED PLANS F5329 (PR): $0.00

TAX ON QUALIFIED PLANS F5329 PER COMPUTER: $0.00

IRAF TAX PER COMPUTER: $0.00

TP TAX FIGURES (REDUCED BY IRAF) PER COMPUTER: $0.00

IMF TOTAL TAX (REDUCED BY IRAF) PER COMPUTER: $0.00

ADVANCED EARNED INCOME CREDIT: $0.00

ADVANCED EARNED INCOME CREDIT AND OTHER EMPLOYMENT TAXES: $0.00

UNPAID FICA ON REPORTED TIPS: $0.00

FORM 4970 ACCUMULATION DISTRIBUTION OF TRUSTS: $0.00

RECAPTURE TAX: F8611: $0.00

HOUSEHOLD EMPLOYMENT TAXES: $0.00

HOUSEHOLD EMPLOYMENT TAXES PER COMPUTER: $0.00

RECAPTURE TAXES: $0.00

TOTAL ASSESSMENT PER COMPUTER: $0.00

TOTAL TAX LIABILITY TP FIGURES: $0.00

TOTAL TAX LIABILITY TP FIGURES PER COMPUTER: $0.00

Payments

FEDERAL INCOME TAX WITHHELD: $0.00

COBRA PREMIUM SUBSIDY: $0.00

ESTIMATED TAX PAYMENTS: $0.00

MAKING WORK PAY AND GOV'T RET CREDIT: $0.00

MAKING WORK PAY AND GOV'T RET CREDIT PER COMPUTER: $0.00

MAKING WORK PAY AND GOV'T RET CREDIT VERIFIED: $0.00

REFUNDABLE EDUCATION CREDIT: $0.00

REFUNDABLE EDUCATION CREDIT PER COMPUTER: $0.00

REFUNDABLE EDUCATION CREDIT VERIFIED: $0.00

EARNED INCOME CREDIT: $0.00

EARNED INCOME CREDIT PER COMPUTER: $0.00

EARNED INCOME CREDIT NONTAXABLE COMBAT PAY: $0.00

SCHEDULE M NONTAXABLE COMBAT PAY: $0.00

FORM 8812 NONTAXABLE COMBAT PAY: $0.00

EXCESS SOCIAL SECURITY & RRTA TAX WITHHELD: $0.00

TOT SS/MEDICARE WITHHELD: F8812: $0.00

FORM 8812 ADDITIONAL CHILD TAX CREDIT: $0.00

FORM 8812 ADDITIONAL CHILD TAX CREDIT PER COMPUTER: $0.00

FORM 8812 ADDITIONAL CHILD TAX CREDIT VERIFIED: $0.00

AMOUNT PAID WITH FORM 4868: $0.00

FORM 2439 REGULATED INVESTMENT COMPANY CREDIT: $0.00

FORM 4136 CREDIT FOR FEDERAL TAX ON FUELS: $0.00

FORM 4136 CREDIT FOR FEDERAL TAX ON FUELS PER COMPUTER: $0.00

HEALTH COVERAGE TX CR: F8885: $0.00

FORM 8801 REFUNDABLE CREDIT FOR PRIOR YEAR MIN. TAX: $0.00

FIRST TIME HOME BUYER CREDIT PER COMPUTER: $0.00

FIRST TIME HOME BUYER CREDIT: $0.00

FIRST TIME HOME BUYER CREDIT VERIFIED: $0.00

PRIMARY NAP FIRST TIME HOME BUYER INSTALLMENT AMT: $0.00

SECONDARY NAP FIRST TIME HOME BUYER INSTALLMENT AMT: $0.00

FORM 2439, 8801, and OTHER CREDIT TOTAL AMT: $0.00

TOTAL PAYMENTS: $0.00

TOTAL PAYMENTS PER COMPUTER: $0.00

Refund or Amount Owed

REFUND AMOUNT: $0.00

APPLIED TO NEXT YEAR'S ESTIMATED TAX: $0.00

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ESTIMATED TAX PENALTY: $0.00

TAX ON INCOME LESS STATE REFUND PER COMPUTER: $0.00

BAL DUE/OVER PYMT USING TP FIG PER COMPUTER: $0.00

BAL DUE/OVER PYMT USING COMPUTER FIGURES: $0.00

FORM 8888 TOTAL REFUND PER COMPUTER: $0.00

Third Party Designee

THIRD PARTY DESIGNEE ID NUMBER: 00000

AUTHORIZATION INDICATOR: 1

THIRD PARTY DESIGNEE NAME: FIRST LAST

Schedule A--Itemized Deductions

MEDICAL/DENTAL

MEDICAL AND DENTAL EXPENSES: $0.00

AGI PERCENTAGE LIMITATION PER COMPUTER: $0.00

NET MEDICAL DEDUCTION: $0.00

NET MEDICAL DEDUCTION PER COMPUTER: $0.00

TAXES PAID

STATE AND LOCAL INCOME TAXES: $0.00

INCOME TAX OR GENERAL SALES TAX: Income Taxes

REAL ESTATE TAXES: $0.00

NEW MOTOR VEHICLE TAXES: $0.00

OTHER TAXES AMOUNT: $0.00

SCH A TAX DEDUCTIONS: $0.00

SCH A TAX PER COMPUTER: $0.00

INTEREST PAID

MORTGAGE INTEREST (FINANCIAL): $0.00

MORTGAGE INTEREST (INDIVIDUAL): $0.00

DEDUCTIBLE POINTS: $0.00

QUALIFIED MORTGAGE INSURANCE PREMIUMS: $0.00

DEDUCTIBLE INVESTMENT INTEREST: $0.00

TOTAL INTEREST DEDUCTION: $0.00

TOTAL INTEREST DEDUCTION PER COMPUTER: $0.00

CHARITABLE CONTRIBUTIONS

CASH CONTRIBUTIONS: $0.00

OTHER THAN CASH: Form 8283: $0.00

CARRYOVER FROM PRIOR YEAR: $0.00

SCH A TOTAL CONTRIBUTIONS: $0.00

SCH A TOTAL CONTRIBUTIONS PER COMPUTER: $0.00

CASUALTY AND THEFT LOSS

CASUALTY OR THEFT LOSS: $0.00

JOBS AND MISCELLANEOUS

UNREIMBURSED EMPLOYEE EXPENSE AMOUNT: $0.00

TOTAL LIMITED MISC EXPENSES: $0.00

NET LIMITED MISC DEDUCTION: $0.00

NET LIMITED MISC DEDUCTION PER COMPUTER: $0.00

OTHER MISCELLANEOUS

OTHER THAN GAMBLING AMOUNT: $0.00

OTHER MISC DEDUCTIONS: $0.00

TOTAL ITEMIZED DEDUCTIONS

TOTAL ITEMIZED DEDUCTIONS: $0.00

TOTAL ITEMIZED DEDUCTIONS PER COMPUTER: $0.00

ELECT ITEMIZED DEDUCTION INDICATOR:

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SCH A ITEMIZED PERCENTAGE PER COMPUTER: $0.00

Schedule D--Capital Gains and Losses

SHORT TERM CAPITAL GAINS AND LOSSES

TOTAL SHORT TERM-SALES PRICE: $0.00

NET SHORT-TERM GAIN/LOSS: $0.00

LONG TERM CAPITAL GAINS AND LOSSES

TOTAL LONG-TERM SALES PRICE: $0.00

CAPITAL GAIN DISTRIBUTIONS (PR): $0.00

NET LONG-TERM GAIN/LOSS: $0.00

TAX COMPUTATION USING MAXIMUM CAPITAL GAINS RATES

28% RATE GAIN: $0.00

UNRECAPTURED SECT: 1250 GAIN: $0.00

SCH D 15% TAX CMPTR: $0.00

CAPITAL GAINS LESS INVEST INCOME PER COMPUTER: $0.00

CAP GAINS TENTATIVE AMT PER COMPUTER (1): $0.00

CAP GAINS TAX AMT PER COMPUTER (1): $0.00

CAP GAINS TENTATIVE AMT PER COMPUTER (2): $0.00

CAP GAINS TAX AMT PER COMPUTER (5): $0.00

CAP GAINS TAX AMT PER COMPUTER (6): $0.00

SCHEDULE D TAX PER COMPUTER: $0.00

Schedule E--Supplemental Income and Loss

INCOME OR LOSS FROM RENTAL REAL ESTATE AND ROYALTIES

PRSNL USE OF RENTAL VAC PROP: 2

TOTAL RENTS RECEIVED: $0.00

TOTAL ROYALTIES RECEIVED: $0.00

MORTGAGE INTEREST PAID: $0.00

TOTAL RENTAL EXPENSE DEDUCTION: $0.00

RENTAL DEPRECIATION EXP OR DEPLETION: $0.00

RENT & ROYALTY INCOME: $0.00

RENT & ROYALTY LOSSES: $0.00

REPAIRS EXPENSE COLUMN A: $0.00

REPAIRS EXPENSE COLUMN B: $0.00

REPAIRS EXPENSE COLUMN C: $0.00

INCOME OR LOSS FROM PARTNERSHIPS AND S CORPS

PRTSHP/CORP PASSIVE INCOME: $0.00

PRTSHP/CORP NONPASSIVE INCOME: $0.00

PRTSHP/CORP PASSIVE LOSS: $0.00

PRTSHP/CORP NONPASSIVE LOSS: $0.00

PARTNERSHIP INCOME: $0.00

PARTNERSHIP LOSS: $0.00

INCOME OR LOSS FROM ESTATES AND TRUSTS

ESTATE/TRUST PASSIVE INCOME: $0.00

ESTATE/TRUST PASSIVE LOSS: $0.00

ESTATE AND TRUST INCOME: $0.00

ESTATE AND TRUST LOSS: $0.00

PASSIVE LOSS NOT REPORTED ON F8582: N

SCH K1 ES PAYMENT INDICATOR: N

INCOME OR LOSS FROM REAL ESTATE MORTGAGE INVESTMENT CONDUITS

REAL ESTATE MORTGAGE INCOME/LOSS: $0.00

SUMMARY

NET FARM RENT INCOME/LOSS: $0.00

(7)

GROSS FARMING & FISHING INCOME: $0.00

Form 1116--Foreign Tax Credit

PART I TAXABLE INCOME OR LOSS FROM FOREIGN SOURCES

GROSS FOREIGN SOURCE INCOME: $0.00

TOTAL APPLICABLE DEDUCTIONS/LOSSES: $0.00

TAXABLE FOREIGN SOURCE INCOME: $0.00

PART II FOREIGN TAXES PAID OR ACCRUED

TOTAL FOREIGN TAX PAID/ACCRUED: $0.00

PART III FIGURING THE CREDIT

TOTAL FOREIGN TAX AVAILABLE FOR CREDIT: $0.00

FOREIGN LOSS ADJUSTMENTS TO TAXABLE INCOME: $0.00

NET FOREIGN SOURCE TAXABLE INCOME: $0.00

MAX ALLOWABLE AMOUNT OF CREDIT: $0.00

GROSS FOREIGN TAX CREDIT: $0.00

PART IV SUMMARY

INTERNATIONAL BOYCOTT CREDIT REDUCTION: $0.00

FOREIGN TAX CREDIT: $0.00

NUM OF ADDITIONAL F1116'S FILED: 0

Form 6251--Alternative Minimum Tax-Individuals

MEDICAL AND DENTAL: $0.00

CERTAIN HOME MORTGAGE INTEREST: $0.00

INVESTMENT INTEREST EXPENSE: $0.00

DEPLETION: $0.00

NET OPERATING LOSS DEDUCTION: $0.00

TAX EXMT INT FROM PRIV ACT BONDS: $0.00

QUALIFIED SMALL BUSINESS STOCK: $0.00

INCENTIVE STOCK OPTIONS: $0.00

ESTATE/TRUST BENEFICIARIES: $0.00

ELECTING LARGE PARTNERSHIPS: $0.00

ADJUSTED GAIN OR LOSS: $0.00

DEPRECIATION OF PROPERTY: $0.00

PASSIVE ACTIVITY LOSS: $0.00

LOSS LIMITATIONS: $0.00

CIRCULATION COSTS: $0.00

LONG TERM CONTRACTS: $0.00

MINING COSTS: $0.00

RESEARCH AND EXPERIMENTAL COSTS: $0.00

INSTALLMENT SALES INCOME: $0.00

INTANGIBLE DRILLING COSTS: $0.00

OTHER: $0.00

ALT TAX NET OPERATING LOSS: $0.00

ALT MINIMUM TAX FOREIGN TAX CR: $0.00

Form 8863 - Education Credits (Hope and Lifetime Learning Credits)

PART III - ALLOWABLE EDUCATION CREDITS

GROSS EDUCATION CR PER COMPUTER: $0.00

TOTAL EDUCATION CREDIT AMOUNT: $0.00

TOTAL EDUCATION CREDIT AMOUNT PER COMPUTER: $0.00

This Product Contains Sensitive Taxpayer Data

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